Thanks to a three-year $3 million investment from the Robert Wood Johnson Foundation, the Public Health National Center for Innovations is launching a three-state pilot in Ohio, Oregon and Washington. The center — created on March 4 by the Public Health Accreditation Board (PHAB) — is an organizational and funding hub aimed at modernizing public health. And this summer, it will add another 10 states, yet unannounced, to the program — which will re-examine the policy and programs that mold how states keep populations healthy and safe.
“Public health has a long history of working with community partners, but what we’re talking about now is working with them and new partners in a slightly different way, in particular in light of health reform,” said Jessica Solomon Fisher, PHAB chief innovation officer.
The policies and technologies surrounding health care are evolving, so it’s time for public health departments to start innovating and making the most of their available resources, Fisher said, from finding new ways to handle payments and reimbursement to community health planning and partnerships between health care and health departments.
“Usually you don’t hear government and innovation in the same sentence, but here we’ve got quite a number of state and local public health partners and also tribal working together to make their side of the governmental work better using innovations that maybe have not been tested before,” said PHAB CEO Kaye Bender. “Rather than say we can’t modernize this or we can’t use this technology because the law says X and the law was written in 1962, for example, then part of the innovation is to persuade legislators and other local policymakers to change the law.”
The center will facilitate the exploration of new ideas in public health so that the best ideas can be standardized and spread across the nation, Kaye explained.
“Any health department that is really looking at itself inside out and saying, 'How can we be more efficient, how can we be more effective, and how can we make sure that what we do is the highest quality that it can be?' has the potential to save lives,” she said.
Each of the three initial pilot states will receive $250,000. Funding will be issued to states for the pursuit of a wide array of public health programs that the states can choose from. In Washington state, the funds will be put toward the development of foundational health measures, public health initiatives that are geared not toward individuals, but the protection of entire populations, explained Jennifer Tebaldi, special assistant to the secretary of Foundational Public Health Services at the Washington State Department of Health.
“[Historically,] public health came in with water safety, safe food, did a lot of things in the environment to help extend people’s lives so they weren’t dying of disease,” Tebaldi said. “But now we have the world of the Affordable Care Act, things are changing in health care; the ability to impact peoples’ health is really in the prevention side, to stop us from getting sick in the first place rather than treat them after they do get sick.”
The state faces two intertwined challenges, Tebaldi said. The first is to innovate and modernize how it addresses public health, and the second is to establish concrete statutory guidelines for what public health means starting in 2017. Specific guidelines will create a mechanism of accountability to ensure the state is pursuing the activities it’s being paid to participate in, and in turn generate more interest from investors that will make an innovative public health program both sustainable and more effective, she explained.
Foundational public health issues occasionally catch the public’s eye when there’s a disaster, like the Fukushima Daiichi nuclear disaster in 2011, or when the news popularizes medical conditions like Ebola or the Zika virus. But much of public health’s purview involves invisible acts to keep everyone safe that no other company or government entity claims responsibility for.
Foundational public health, Tebaldi said, includes things like site inspections, drinking water monitoring, paralytic shellfish testing, radiation control, industrial regulation, health profession and facility licensing, and data collection. As government becomes more sophisticated with how its data is used and how it forms relationships with research institutions and private companies, opportunities for life-saving data innovation grow.
“We do a lot of surveillance. Public health collects a lot of data, and so you think about birth and death records, marriage, hospitalization records, birth defects registry and surveys,” Tebaldi said. “Data can do a lot for us, too. That’s another one of the big changes in public health and the health-care system is that push to combine lots of data together, and a lot of the things we collect are building blocks for those connections. … This is all part of modernizing what we do.”
